Provider Demographics
NPI:1043388515
Name:VIERS, JO ANNE ROE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JO ANNE
Middle Name:ROE
Last Name:VIERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2050 MEADOWVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-7332
Mailing Address - Country:US
Mailing Address - Phone:423-230-5000
Mailing Address - Fax:423-230-5010
Practice Address - Street 1:1 MEDICAL PARK BLVD
Practice Address - Street 2:SUITE 458-W
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-7430
Practice Address - Country:US
Practice Address - Phone:423-844-4975
Practice Address - Fax:423-844-4987
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1059099363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P22536Medicare UPIN